Jump to content
Premed 101 Forums
kbilal08

Us Grad - Canadian Citizen - Want To Come Home!

Recommended Posts

Hey Guys,

I'm currently a MS3 at a top 15 US school in New York city.  I really want to come back home to Canada.  I'm confused about a lot of things in terms of the CARMs cycle.  If anyone could answer the following questions, then I would really appreciate it:

 

1) According to the CARMs 2016 report, approximately 30 people in my position (US MD grad Canadian citizens) applied to CARMS and only 17 matched.  That is an abysmal match rate of about 50 percent.  Could you tell me why you guys think that this is?  Do Canadian schools really look down on US graduates??  Also could it be that those 13 who did not match, got matched in to some US school and decided to not come to Canada?

 

2) That brings me to my second question, are there two separate matching cycles completely independent?  Is it possible to match in to two institutions (one in Canada, one in USA)??

 

3) Although I hear a lot about the US application cycle, i'm removed from CARMs so i'm not sure how to make sense of some of the statistics.  For example, for 2016 there were 83 positions set aside for CMGs in Diagnostic Radiology.  Only 73 matched.  That left the quota unfilled by 10 slots.  However there were over 100 people who applied to Diagnostic Radiology?!  Do school opt to leave open slots rather than take sub-par candidates?

 

4) The statistics in CARMS do not show me the program that those lucky 17 USMD Canadian citizens matched in to.   But can I assume that they are only matching in to less competitive residencies?  Is there no hope if I wish to pursue Radiology in Canada?

 

I would really appreciate if people who have gone through this similar situation could reach out to me, i'm really confused about all of this.

 

Share this post


Link to post
Share on other sites

Hey, I'm in a similar situation.

 

1. Some people dual apply but ultimately choose to stay in the States for whatever reason, so they withdraw from carms. Some other people don't receive interviews in places they would choose over a city in the States, so they withdraw. Some people just don't match in carms. That 50% unmatched is kind of misleading. I don't think Canadian schools look down at U.S. schools.

 

2. No you can't match in both, if you match in carms you are automatically withdrawn from nrmp (they talk to each other). Carms happens before the U.S. match so thats why some applicants drop out of the match if they don't interview in places they would choose over the States. If you don't match carms, then you will go though nrmp for the States.

 

3. Yes

 

4. Most Canadians from the U.S. match into FM. However, you can apply to the more competitive specialties. You have to do aways in Canada and get strong letters (this is the only disadvantage we face, since we get less opportunities for rotations in Canada). If you are smart about planning and depending on your schools policies, it is doable. Have a back-up plan.

Share this post


Link to post
Share on other sites

I'm no expert so take what I say with a grain of salt. Assuming you apply to both Canadian and US schools, the Canadian matches first, so if you are selected in Canada, that is the end of it; otherwise, your applications in US proceed.

 

You are advised to do an elective in the program(s) where you will apply in CaRMS, as you want face time with the people and program with whom you will be working. They want to get to know you otherwise than on paper. I cannot imagine any program accepting a candidate they consider not up to standards.  

Share this post


Link to post
Share on other sites

 

3) Although I hear a lot about the US application cycle, i'm removed from CARMs so i'm not sure how to make sense of some of the statistics.  For example, for 2016 there were 83 positions set aside for CMGs in Diagnostic Radiology.  Only 73 matched.  That left the quota unfilled by 10 slots.  However there were over 100 people who applied to Diagnostic Radiology?!  

 

In addition to the above comments, it's also possible that the unfilled quota was in programs that weren't considered or ranked by a number of applicants (possibly to due to geographical or other constraints).  Programs are applied to individually - not every applicant will apply to every program.    

Share this post


Link to post
Share on other sites

Thank you for the replies everyone, i'm learning a great deal from this discussion.  I wanted to ask a few follow up questions:

 

1) There is limited elective time available to me at the end of 3rd year and in 4th year before the applications.  How should I maximize the elctive time?  Should I take a lot of 2 week electives at different schools?  Or should I take a few 4 week electives to get better LoRs?  Or the third option would be a mix and match where by I take 4 weeks at schools i really like and 2 weeks at all others.  

 

 

2) Even if I take 2 week electives, I may only be able to do electives at 6-7 schools due to time constraints.  Does this mean I only have a shot at those 6-7 schools?  Will I not get interviews from other schools in the country if I don't do electives there?  How do CMGs normally deal with this? because I cant imagine all applicants taking electives EVERYWHERE for a certain discipline?

 

3) Should I be doing electives for my "back up" plan as well?  Say my back up is Pathology where the match rate is almost 100%.  Do I need to do electives in Pathology for interviews?

Share this post


Link to post
Share on other sites

1. My school only lets me do one month rotations so all of mine are 4 weeks. I'll get 3-4 months of electives before carms and they will be split between 2 specialties (one competitive, one not as competitive) and 2 schools. I'm hoping my LOR's from these will be able to carry weight to other schools. I think 2 week electives would be good if you want to go to multiple schools?

 

2. As a U.S. grad I'm not sure. I'm sure some schools are more selective than other so it depends on the school and program.

 

3. I will be doing electives in 2 specialties that I would be equally happy in, so I guess one of them would be a "back up". I think it is the smart thing to do given that no interview is guaranteed. 

 

Another thing to note is that by doing all your electives in Canada, it will make your American application weaker, due to lack of American LORs, audition rotations etc. If matching in America is a real possibility for you, then a balancing act may be needed.

Share this post


Link to post
Share on other sites

Thank you for the replies everyone, i'm learning a great deal from this discussion.  I wanted to ask a few follow up questions:

 

1) There is limited elective time available to me at the end of 3rd year and in 4th year before the applications.  How should I maximize the elctive time?  Should I take a lot of 2 week electives at different schools?  Or should I take a few 4 week electives to get better LoRs?  Or the third option would be a mix and match where by I take 4 weeks at schools i really like and 2 weeks at all others.  

 

 

2) Even if I take 2 week electives, I may only be able to do electives at 6-7 schools due to time constraints.  Does this mean I only have a shot at those 6-7 schools?  Will I not get interviews from other schools in the country if I don't do electives there?  How do CMGs normally deal with this? because I cant imagine all applicants taking electives EVERYWHERE for a certain discipline?

 

3) Should I be doing electives for my "back up" plan as well?  Say my back up is Pathology where the match rate is almost 100%.  Do I need to do electives in Pathology for interviews?

2) No, you can definitely get interviews(field dependent) without having done an elective there. THE FLIP SIDE IS ALSO TRUE: You can do an elective at a place, and STILL not get an interview. Definitely many people get interviews at schools without having done electives at them. 

Share this post


Link to post
Share on other sites

One reason for the low match rate for USMDs in CaRMS, is because they don't bother applying as broadly as a CMG would, and only apply to the competitive/desirable spots for their own purposes.

Example: Applicant applying to FM only in big cities, or applying to URO only at certain programs in places they find desirable. They are not applying broadly to all FM programs, or URO programs, because they would rather attend US programs that they would rank higher in the NRMP match.    This leads to an artificially lower match rate for USMDs in the CaRMs match. 

Because of the simple fact that they have more options in the US to also consider.  And most of the time the US match happens after CaRMS, so it would not be in their favour to rank an undesirable Canadian program, if they would much rather attend a more desirable US program. 

Share this post


Link to post
Share on other sites

In addition to the above comments, it's also possible that the unfilled quota was in programs that weren't considered or ranked by a number of applicants (possibly to due to geographical or other constraints).  Programs are applied to individually - not every applicant will apply to every program.    

Exactly this.

 

Different people have different preferences. Many people only apply to a specific subset of programs. So you may have more desirable programs(due to geography, reputation, etc) that get significantly more applicants, than less desirable programs. Skews the numbers.

Share this post


Link to post
Share on other sites

One reason for the low match rate for USMDs in CaRMS, is because they don't bother applying as broadly as a CMG would, and only apply to the competitive/desirable spots for their own purposes.

 

Example: Applicant applying to FM only in big cities, or applying to URO only at certain programs in places they find desirable. They are not applying broadly to all FM programs, or URO programs, because they would rather attend US programs that they would rank higher in the NRMP match.    This leads to an artificially lower match rate for USMDs in the CaRMs match. 

 

Because of the simple fact that they have more options in the US to also consider.  And most of the time the US match happens after CaRMS, so it would not be in their favour to rank an undesirable Canadian program, if they would much rather attend a more desirable US program. 

 

exactly - why rank ALL the programs in canada in your area if some of them are far less desirable than what you are likely to get in the US. You could argue it is better to rank the places you desire specifically in Canada, and then apply broadly in the US to prevent going unmatched worst case. 

Share this post


Link to post
Share on other sites

One reason for the low match rate for USMDs in CaRMS, is because they don't bother applying as broadly as a CMG would, and only apply to the competitive/desirable spots for their own purposes.

 

Example: Applicant applying to FM only in big cities, or applying to URO only at certain programs in places they find desirable. They are not applying broadly to all FM programs, or URO programs, because they would rather attend US programs that they would rank higher in the NRMP match.    This leads to an artificially lower match rate for USMDs in the CaRMs match. 

 

Because of the simple fact that they have more options in the US to also consider.  And most of the time the US match happens after CaRMS, so it would not be in their favour to rank an undesirable Canadian program, if they would much rather attend a more desirable US program. 

 

While I'm sure some US-trained Canadians fall into this category, I would still wager that most of those who apply back to Canada are like the OP, with a similarly strong desire to return home, and broad applications to match. It could be argued that since there are so many programs in the States, those who even bother with Canada at all are likely to be more than just a little bit committed. Sure the match rate is 50%, but it's 50% of a small number, and not as bad as it appears.

Share this post


Link to post
Share on other sites

For US Grads with Canadian citizenship, you are considered as CMGs for CaRMS. You could always argue that Canadian schools favour Canadian Medical Students. Undoubtedly, each school favours its own students, each province favours its own IP med students for medical residency.

But if you have a strong application, you should be considered equally as a CMG. If you top choice speciality is competitive, then, yes it would be to your best interest to do electives everywhere. 2-weeks elective is perfect to get yourself known to the programs, while touring more schools.

 

I wonder if for NRMP match, CMGs are considered equally as US med students? Perhaps the reverse is not true...I don't think a lot of CMGs apply to NRMP match, because being matched to CaRMS automatically withdraws you from NRMP match.

I guess that for USMG wanting to come back to Canada, at least the CaRMS match day is before NRMP match day... :)

Share this post


Link to post
Share on other sites

For US Grads with Canadian citizenship, you are considered as CMGs for CaRMS. You could always argue that Canadian schools favour Canadian Medical Students. Undoubtedly, each school favours its own students, each province favours its own IP med students for medical residency.

But if you have a strong application, you should be considered equally as a CMG. If you top choice speciality is competitive, then, yes it would be to your best interest to do electives everywhere. 2-weeks elective is perfect to get yourself known to the programs, while touring more schools.

 

I wonder if for NRMP match, CMGs are considered equally as US med students? Perhaps the reverse is not true...I don't think a lot of CMGs apply to NRMP match, because being matched to CaRMS automatically withdraws you from NRMP match.

I guess that for USMG wanting to come back to Canada, at least the CaRMS match day is before NRMP match day... :)

There's a few issues here: a) only Canadian citizens or permanent residents can apply to the CMG stream of the CaRMS match - but correspondingly the reverse needn't true for the NRMP. So inherently, the comparison is somewhat unbalanced since different situations are being compared;b )The fact that CaRMS occurs earlier than NRMP isn't of importance when applying to NRMP -only (possibly) for matching. The low NRMP applicant rate is in part more likely due to visa requirements (and limitations) as well as the necessity MLE Steps 1 & 2 completion; c) Outside of beneficial geographical location (and in Quebec linguistic reasons), I don't believe there is any preference for IP grads.

Share this post


Link to post
Share on other sites

Hey OP, also in similar situation as you. One thing that we are out of luck with (unless there are ways around this that I haven't considered or am unaware of), is the insane cost difference for doing away electives for non CMGs vs CMGs. Looking at the AFMC Portal, the average costs are upwards of a grand per away elective in Ontario. That's a lot for a two week elective, and personally limits the number of aways I can do at the moment. 

Share this post


Link to post
Share on other sites

Hey OP, also in similar situation as you. One thing that we are out of luck with (unless there are ways around this that I haven't considered or am unaware of), is the insane cost difference for doing away electives for non CMGs vs CMGs. Looking at the AFMC Portal, the average costs are upwards of a grand per away elective in Ontario. That's a lot for a two week elective, and personally limits the number of aways I can do at the moment. 

I wonder, since USMDs are considered CMGs for CaRMS matching, if you are considered the same for AFMC portal? Probably a long shot, but worth contacting them directly about and asking(referencing the fact that you're considered CMG for CaRMS...).

 

Unless of course they explicitly say USMD = pay international fees

Share this post


Link to post
Share on other sites

I wonder, since USMDs are considered CMGs for CaRMS matching, if you are considered the same for AFMC portal? Probably a long shot, but worth contacting them directly about and asking(referencing the fact that you're considered CMG for CaRMS...).

 

Unless of course they explicitly say USMD = pay international fees

 

Elective portal is completely different than CaRMS. I believe each school will have its own rules. Big reason the costs are higher for international students has to do with insurance costs, which are covered for Canadian students but I doubt is covered for US students. Likewise, Canadian schools has reciprocal teaching arrangements with each other, but likely wouldn't with their American counterparts. Elective students eat up resources, and those have to be covered one way or another.

Share this post


Link to post
Share on other sites

Elective portal is completely different than CaRMS. I believe each school will have its own rules. Big reason the costs are higher for international students has to do with insurance costs, which are covered for Canadian students but I doubt is covered for US students. Likewise, Canadian schools has reciprocal teaching arrangements with each other, but likely wouldn't with their American counterparts. Elective students eat up resources, and those have to be covered one way or another.

 

USMGs shouldn't have problem securing electives in Canada provided the school has space. I've received all electives that I've applied for. You just have to be proactive and submit the first day with all of your documents in order for the dates you want. Also, be a nuisance to your school's administration to get you verified ASAP by the schools who process you for your electives.

 

Toronto considers USMGs and CMGs the same. The two other schools I've applied for and other schools I've looked at consider us international. The only downside I can see is the cost difference of the application (which is like said by others, is mostly for malpractice insurance).

Share this post


Link to post
Share on other sites

USMGs shouldn't have problem securing electives in Canada provided the school has space. I've received all electives that I've applied for. You just have to be proactive and submit the first day with all of your documents in order for the dates you want. Also, be a nuisance to your school's administration to get you verified ASAP by the schools who process you for your electives.

 

Toronto considers USMGs and CMGs the same. The two other schools I've applied for and other schools I've looked at consider us international. The only downside I can see is the cost difference of the application (which is like said by others, is mostly for malpractice insurance).

 

Agreed, USMGs shouldn't have much more challenge getting electives than CMGs (but even for CMGs applying as soon as possible that's not a guarantee - speaking from personal experience). However, the point I was speaking to was the cost difference.

Share this post


Link to post
Share on other sites

USMD here going through CARMS and NRMP (feel free to message me questions, cause its a pain to navigate on your own)

 

1) Dont trust the stats as people have said many applicants only want specific schools so their CARMS ROL may only be 2 long!

 

2) You have to make sure you tell both systems you are registered in the other and they will make sure you only get 1 match 

 

3) Many USMDs apply to family but I know an equal number who didn't and still match in CARMS (I even know a few rads), just make sure you are doing electives in Canada. Electives don't guarantee  you interviews at that school but you need strong Canadian letters to get interviews (these tend to be regional Ontario letters = Ontario and Atlantic interviews, Man, AB, Sask and UBC, tend to get interviews in west of Ontario. N.B. the sample size on this is small). I also know some pediatric residents from well known US schools who did no electives in Canada. 

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×